EPIDERMAL GROWTH-FACTOR RECEPTOR (EGFR) - RESULTS OF A 6 YEAR FOLLOW-UP-STUDY IN OPERABLE BREAST-CANCER WITH EMPHASIS ON THE NODE NEGATIVE SUBGROUP
EPIDERMAL GROWTH-FACTOR RECEPTOR (EGFR) - RESULTS OF A 6 YEAR FOLLOW-UP-STUDY IN OPERABLE BREAST-CANCER WITH EMPHASIS ON THE NODE NEGATIVE SUBGROUP
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DOI：
10.1038/bjc.1991.30
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发表时间：
1991-01-01
影响因子：
8.8
通讯作者：
HARRIS, AL
中科院分区：
文献类型：
--
作者：
NICHOLSON, S;RICHARD, J;HARRIS, AL
需要更准确的标准来选择淋巴结阴性乳腺癌患者进行全身辅助治疗。 表皮生长因子受体（EGFr）的表达以前已被证明是负相关的雌激素受体（ER）在可手术的乳腺癌患者，并与较差的预后。 对231例可手术乳腺癌患者的肿瘤样本进行EGFr和ER分析，术后随访长达6年。 分析时仍存活患者的中位随访时间为45个月。 35%的患者（82例）患有肿瘤，I-125-EGF结合率（EGFr +）大于10 fmol mg-1，47%（109例）的患者膀胱收缩期ER浓度> 5 fmol mg-1（ER +），EGFr和ER之间存在显着的负相关关系（P < 0.00001）。 在单变量分析中，EGFr作为所有患者无复发和总生存期的预后标志物仅次于腋窝淋巴结状态（P < 0.001，对数秩）。 对于腋窝淋巴结阴性的患者，EGFr在预测复发和生存方面上级ER（P < 0.01和P < 0.005分别与P < 0.1和P < 0.1，对数秩）。 在多变量（考克斯模型）分析中，在EGFr、ER、大小和分级中，只有EGFr可预测淋巴结阴性患者的无复发或总生存期（分别为P = 0.05和P = 0.026）。 EGFr已被证明是淋巴结阴性乳腺癌患者预后不良的标志物。 由于EGFr +肿瘤患者不太可能对激素治疗有反应，因此有可能选择他们进行全身辅助化疗试验。
More accurate criteria are required for the selection of patients with node-negative breast cancer for systemic adjuvant therapy. Expression of epidermal growth factor receptor (EGFr) has been shown previously to be inversely related to oestrogen receptor (ER) in patients with operable breast cancer and to be associated with a poorer prognosis. Analysis of EGFr and ER was performed on tumour samples from 231 patients with operable breast cancer followed for up to 6 years after surgery. The median duration of follow-up in patients still alive at the time of analysis was 45 months. Thirty-five percent of patients (82) had tumours with greater than 10 fmol mg-1 I-125-EGF binding (EGFr +) and 47% (109) and cystolic ER concentrations > 5 fmol mg-1 (ER +), with a marked inverse relationship between EGFr and ER (P < 0.00001). In a univariate analysis EGFr was second only to axillary node status as a prognostic marker for all patients both in terms of relapse-free and overall survival (P < 0.001), log rank). For patients with histologically negative axillary nodes EGFr was superior to ER in predicting relapse and survival (P < 0.01 and P < 0.005 respectively compared to P < 0.1 and P < 0.1, log rank). In a multivariate (Cox model) analysis only EGFr, out of EGFr, ER, size and grade, was predictive for either relapse-free or overall survival for patients with node-negative disease (P = 0.05 and P = 0.026 respectively). EGFr has been shown to be a marker of poor prognosis for patients with node-negative breast cancer. Since patients with EGFr + tumours are unlikely to respond to hormone therapy it may be possible to select them for trials of systemic adjuvant chemotherapy.